1427293067 NPI number — MRS. DIANE MARIE WEINREICH APRN, FNP-BC

Table of content: MRS. DIANE MARIE WEINREICH APRN, FNP-BC (NPI 1427293067)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427293067 NPI number — MRS. DIANE MARIE WEINREICH APRN, FNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEINREICH
Provider First Name:
DIANE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN, FNP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427293067
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 JEFFERSON
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARSHALL
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65340-2106
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-831-1175
Provider Business Mailing Address Fax Number:
660-831-3364

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 N JEFFERSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARSHALL
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65340-2148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-831-1175
Provider Business Practice Location Address Fax Number:
660-831-3364
Provider Enumeration Date:
12/11/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  142617 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2008009796 . This is a "AMERICAN NURSES CREDENTIALING CENTER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 420012554 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".